New York hospitals prepare for next healthcare battleground: children

With the American Health Care Act presently off the table, groups representing New York hospitals and other healthcare providers are turning their attention to the next legislative battleground in Washington, D.C.: the reauthorization of funding for the State Children's Health Insurance Program, or CHIP, which expires at the end of September.

Republicans might attempt to slip some of their proposed reforms into that bill, said Bea Grause, president of the Healthcare Association of New York State.

"It could be a vehicle for some of the repeal initiatives," she said. "That's why it's important to be vigilant."

New York has its own subsidized health insurance program, called Child Health Plus, for children under the age of 19 who are not eligible for Medicaid. But the state receives federal matching funds for that program through CHIP.

The Medicare Access and CHIP Reauthorization Act of 2015, which prevented CHIP from sunsetting two years ago, was passed with bipartisan support.

While the program probably won't face the chopping block, negotiations to renew its funding provide another opportunity for lawmakers to pursue their legislative agendas, said Rebecca Farley, vice president of policy and advocacy for the National Council for Behavioral Health, during a conference hosted by the Coalition for Behavioral Health in Manhattan Thursday.

"Reauthorizing CHIP is going to be expensive," said Farley. "With fiscal conservatives controlling Congress, the question always becomes, Will they demand cuts elsewhere to offset the cost of CHIP?"

She added that Democrats in Washington, D.C. are particularly invested in reauthorizing the program.

"Will Republicans hold it over their heads to try to get their buy-in on some other conservative priorities they could potentially sneak into that CHIP reauthorization bill?" Farley asked.

However, New York hospital groups also see CHIP as an opportunity to advance their own policy agenda. They are particularly focused on preventing upcoming cuts to federal subsidies for hospitals that serve disproportionate shares of patients who are uninsured or on Medicaid, which are slated to take effect on October 1. The cuts would be most painful for NYC Health + Hospitals, the city's already-ailing public health system.

"CHIP has received bipartisan support in the past, which may help us make our case on [disproportionate share hospital payment] cuts with both Republicans and Democrats in our Congressional delegation," wrote Kenneth Raske, president of the Greater New York Hospital Association, in a memo to members Monday.

He added, "There is support within Congress to once again postpone the cuts or eliminate them altogether."

Whether President Donald Trump and members of Congress will shift toward bipartisan negotiations on healthcare reform beyond this bill remains to be seen.

"I don't know, but I certainly hope there would be an opportunity to have a bipartisan conversation around what would be better for patients and what would be better to improve the delivery of healthcare in every state in the country," said Grause. "So far, the conversation has been heavy on rhetoric and light on the reality of where we are in healthcare today."